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一例心脏血管肉瘤合并肺结核;诊断挑战与文献综述

A case of cardiac angiosarcoma and pulmonary tuberculosis; diagnostic challenges and review of literature.

作者信息

Pourkia Roghayeh, Faghanzadeh Ganji Ghasem, Vakili Sadeghi Mohsen, Ziaie Naghmeh, Rezaeian Nahid, Dehghani-Tafti Faezeh, Ghorbani Hossein, Ansari Ramandi Mohammad Mostafa

机构信息

Department of Cardiology, Babol University of Medical Sciences, Babol, Iran.

Department of Cardiac Surgery, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.

出版信息

Caspian J Intern Med. 2021;12(Suppl 2):S500-S504. doi: 10.22088/cjim.12.0.500.

Abstract

BACKGROUND

Patient symptoms and primary investigational methods may be misleading at some points in patient management and can consume a lot of time. Sarcomas are rare malignancies and contribute 1% of all cancers of adult.

CASE PRESENTATION

A rare case of primary cardiac angiosarcoma is presented, who was first treated because of lung tuberculosis and then with only slight improvement in symptoms, further investigations were done showing right ventricular enlargement and pericardial effusion. Eventually, after ruling out pulmonary embolism and constrictive pericarditis, investigations lead to the diagnosis of primary cardiac angiosarcoma. The patient went under surgery to remove the tumor but he still had residual mass left, leading to chemotherapy and then radiotherapy. Although the tumor has a poor prognosis, our patient has managed to survive a year by now and is doing good for 6 months after radiotherapy.

CONCLUSION

The case describes the importance of having in mind different differential diagnosis in managing patients and the role of multi-modality imaging in guiding diagnosis and treatment.

摘要

背景

在患者管理的某些阶段,患者症状和主要检查方法可能具有误导性,并且会耗费大量时间。肉瘤是罕见的恶性肿瘤,占成人所有癌症的1%。

病例报告

本文报告一例罕见的原发性心脏血管肉瘤病例,该患者最初因肺结核接受治疗,症状仅稍有改善,进一步检查显示右心室扩大和心包积液。最终,在排除肺栓塞和缩窄性心包炎后,检查确诊为原发性心脏血管肉瘤。患者接受了手术切除肿瘤,但仍有残留肿块,随后进行了化疗和放疗。尽管该肿瘤预后较差,但我们的患者至今已存活一年,放疗后6个月情况良好。

结论

该病例描述了在管理患者时考虑不同鉴别诊断的重要性以及多模态成像在指导诊断和治疗中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddf2/8559658/5fd8d40b2a91/cjim-12-500-g001.jpg

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